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Journal of Pediatric and Neonatal Individualized Medicine 2016;5(2):e050234
doi: 10.7363/050234 Received: 2016 Aug 18; accepted: 2016 Aug 25; published online: 2016 Sept 06
Editorial
Past and future of stem cells:
from Prometheus to regenerative
medicine
Gavino Faa1, Vassilios Fanos2, Antonio Giordano3,4
1
Department of Surgical Sciences, Division of Pathology, University of Cagliari, Cagliari, Italy
2
Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section, AOU and University of Cagliari,
Cagliari, Italy
3
Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, Temple
University, Philadelphia, PA, USA
4
Oncology Research Center of Mercogliano (CROM), Istituto Nazionale Tumori “Fondazione G.
Pascale” – IRCCS, Naples, Italy
Proceedings
Proceedings of the 2nd International Course on Perinatal Pathology
(part of the 11th International Workshop on Neonatology · October 26th-31st, 2015)
Cagliari (Italy) · October 31st, 2015
Stem cells: present and future
Guest Editors: Gavino Faa (Cagliari, Italy), Vassilios Fanos (Cagliari, Italy),
Antonio Giordano (Philadelphia, USA)
“Then indeed the winged hound of Zeus, the ravening eagle, coming an
unbidden banqueter the whole day long, with savage appetite shall tear
your body piecemeal into great rents and feast his fill upon your liver
until it is black with gnawing.”
Aeschylus, Prometheus Bound (ca. 460 BC)
Keywords
Stem cells, regenerative medicine, brain, heart, lung, kidney, adrenal glands,
liver, pancreas, gut, milk.
Corresponding author
Vassilios Fanos, Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section, AOU and
University of Cagliari; email: [email protected].
How to cite
Faa G, Fanos V, Giordano A. Past and future of stem cells: from Prometheus to regenerative medicine.
J Pediatr Neonat Individual Med. 2016;5(2):e050234. doi: 10.7363/050234.
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Journal of Pediatric and Neonatal Individualized Medicine • vol. 5 • n. 2 • 2016
The salamander limb regenerates completely
after amputation and the heart of the zebrafish
returns to normal even after an extensive injury [1].
What is it that makes all this possible? The
answer is the presence of stem cells, which in these
animals are quite efficient. We humans have lost this
capacity, but researchers are working incessantly to
control cell reprogramming and make regenerative
medicine possible and close at hand [1, 2].
Facultative liver stem cells have long been
thought to be an important source of new hepatocytes during chronic liver injury. However, even
this longstanding paradigm is being challenged by
some recent data: contrary to prevailing stem-cellbased models of regeneration, virtually all new
hepatocytes come from preexisting hepatocytes [3,
4]. Life is complicated.
All Quiet on the Western Front. It is probable
that the ancient Greeks knew about the regenerative
properties of the liver. Suffice it to recall the story
of Prometheus punished by the gods for revealing
the secret of fire. He was chained to a rock where
by day an eagle fed on his liver, which regenerated
itself punctually during the night (Fig. 1) [5].
The Proceedings of the 2nd International Course
on Perinatal Pathology (part of the 11th Inter-
Figure 1. Vector illustration inspired by a Laconic Kylix representing Atlas and Prometheus (560-550 BC, found at Cerveteri
and now at Vatican Museums, Rome). Prometheus is chained to a rock. During the day an eagle feeds on his liver, which
regenerates during the night.
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Faa • Fanos • Giordano
Journal of Pediatric and Neonatal Individualized Medicine • vol. 5 • n. 2 • 2016
national Workshop on Neonatology), held in Cagliari (Italy) on October 31, 2015, are presented
in this issue and in the previous issue of the
Journal of Pediatric and Neonatal Individualized
Medicine. These papers, the fruit of the work of
many researchers, fit into this ancient and at the
same time most modern scenario. The hard core of
researchers in the Division of Pathology and the
Neonatal Intensive Care Unit, Neonatal Pathology
and Nursery of Cagliari is supported by a group of
international collaborators from the United States,
Germany and Belgium, thus ensuring a significant
interdisciplinary approach. And so, the itinerary,
or better still the adventure, must necessarily
start from the brain, the noblest organ, the most
complex “thing” in nature.
The first two articles analyse the different refined
pathways used by neural stem cells in the diverse
stages of their proliferation and differentiation [6,
7]. These studies may be fecund in many areas,
but undoubtedly one of the most fascinating is
represented by the possible practical consequence
in the preterm neonate’s brain for the prevention
and treatment of cerebral degeneration in the
adult [8].
And what about the heart? An open future or a
mirage? This is the question posed by one [9] of
the two articles [10] devoted to this organ. If we
observe experiments on animals, we find reasons
for optimism [11]. Neonatal immunohistochemistry
can shed light on intriguing correlations between
perinatal markers, aging, and carcinogenesis.
The lung is considered a possibly renewable
organ considering its ability to respond quickly to
cell damage thanks to the presence of multipotent
stem cells [12, 13]. These cells represent interesting
prospects in the treatment of bronchopulmonary
dysplasia [14].
As many as four articles are devoted to the
adrenal gland [15] and kidney [16-18], with an eye
on kidney physiological regenerative medicine in
the preterm neonate in preventing chronic renal
insufficiency. In the last few years striking progress
has been made in understanding cell connections at
the interface between stem and progenitor cells in
stem-cell niches [16]. We have extensively studied
this topic and the potentialities of renal regeneration
[19-26].
In spite of the intuitions of the ancient Greeks,
much work needs to be done on the liver. The paper
on this organ represents a starting point leading
to further contributions allowing more precise
characterization of hepatic stem cells [27].
Stem cells: past and future
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As concerns the pancreas, its stem cells suggest
opportunities for transforming the fruits of basic
research into clinical tools [28-30].
The gut is considered the second brain and
represents a scenario of extraordinary interest
owing to the network of bidirectional biological
messages exchanged by brain, gut, microbiota,
immune system, and stem cells [31-33]. An understanding of the cryptic language of these
messages can help us to comprehend and prevent
disastrous diseases such as neonatal necrotizing
enterocolitis [34].
Last but not least, we must consider the stem cells
of mother’s milk [35-37] which, from the neonatal
intestinal lumen, are transported to the several organs, among which the brain, in which they become
neurons, oligodendrocytes and astrocytes. This is a
discovery that changes many things with respect to
our knowledge today [38].
As can be seen, many actors are present on
the stage in the archipelago of complexity and
the uninterrupted string of perinatal programming
which, from fetus to adult, orients and governs our
health, for better or for worse.
We hope that our working together will advance,
albeit slightly, our knowledge and understanding,
and lead us on towards the future with the enthusiasm
and determination of our young colleagues.
We hope that all this research, only in appearance detached from reality, will soon become
opportunities for treating all our patients, young or
old, who have an extraordinary need for them.
May this science bordering on the imaginary
soon become a concrete reality full of hope!
Acknowledgements
Vector illustration in Fig. 1 is by Eleonora Fanos.
Declaration of interest
The Authors declare that there is no conflict of interest.
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